Date Received: / Date Approved: / R&LSC#

UTSA Application for Laser Use

IMPORTANT: All classes 3b and 4 lasers used at UTSA are required to have an approval from the Radiation & Laser Safety Committee through Environmental Health, Safety & Risk Management (EHSRM) and must be registered with the State of Texas. Safe laser use and procedural compliance are the responsibilities of the Principal Investigator (PI). An approved application is required for each laser or laser system individually.

Date: / PI: / Department:
Building: / Room: / PI’s Phone Number:
Specifications of Laser System to be Used
Laser Type: / Class
Manufacturer and Model: / Serial#:
Continuous Wave Pulsed Both / Is This A Pumping Laser? / Yes No
Continuous Wave Specifications / Pulsed Specifications
Wavelength(s) (nm) / Wavelength (nm)
Max Power (W) / Min Pulse Duration (sec)
Operating Power (W) / Frequency Repetition Rate Range (Hz)
Max Energy (J)
Operating Energy (J)
Type of Laser / Gas Liquid Solid State Other:
Tunable / Yes No / Simultaneous Wavelengths / Yes No
Tunable Wavelength Ranges
Beam Diameter (cm) / Beam Divergence (mradian)
Beam Diameter and Divergence were Measured: / 1/e 1/e2 50% Other:
User Serviceable: Yes No / If No, Service Company:
Check all that Apply to the Laser System
Manufacturers Operation Manual Availiable / Exposed beam path
Use of cryogens / Use of beam focusing optics
High noise level (>85 dB) / Use of frequency doubling crystal
Chilled-water cooled / Laser cutting/welding
Self-modified laser / User-fabricated laser
Use of compressed gases Specify
Involves high voltage applications Specify
Laser Safety Eyewear Information
Manufacturer / Optical Density @ Wavelength(s) Protected / ANSI Approved (Y/N) / Available Onsite (Y/N)
Personnel Training Table (Including PI)
Name / Banner ID / Course#/Date / Title/ Student Classification / Comments

Required Attachments

Note: Attach and Label each response to the following questions with the corresponding number. If a question does not apply, then please check the does not apply box for that question.

1.  I have attached the Manufacturer’s laser specification sheet.

I have attached the appropriate response / I have attempted to contacted the manufacturer
and the specification sheet was not available.

2.  Laser Location: Attach a sketch of the location of the laser system(s) in the designated room and/or provide photos of the lab and laser location.

I have attached the appropriate response / Does not apply to this laser system

3.  Provide a brief outline in terms of the application of the laser system(s) for the project (Attach additional pages as necessary).

Note: The committee approval process is not to evaluate the nature of the research or the appropriateness of the application of lasers to the research activities, but to identify safety issues related to the project.

I have attached the appropriate response / Does not apply to this laser system

4.  Attach standard operating procedures (SOPs) for the alignment and operation of each laser system (follow guidance at the end of this document for writing SOPs).

I have attached the Alignment SOP Experimental SOP Submitted
Experimental SOP will be submitted within 90 days from preliminary approval.

5.  Is there any chance that gas or aerosols will be formed? If so, what method(s) will be used to prevent inhalation of the released gas or aerosols?

I have attached the appropriate response / Does not apply to this laser system

6.  Indicate what methods will be used to define a laser control area. This area is designated where the laser has the potential to cause injury (the entire room, inside laser curtain, behind protective barrier, etc.).

I have attached the appropriate response / Does not apply to this laser system

7.  Specify precautions and procedures to be used by personnel to:

a.  Prevent eye and/or skin injuries (attach emergency SOPs).

b.  Prevent unauthorized use or removal of the laser system.

c.  Prevent beam exposure in work areas and in adjacent area.

I have attached the appropriate response / Does not apply to this laser system

8.  Statement of previous course(s), training or experience with laser(s)

a.  On-the-Job Training (OJT) -Include copy of OJT signature sheet which includes topic(s) covered.

b.  Experience

c.  Formal Training - Include a copy of any applicable certificates.

I have attached the appropriate response

9.  Have you had any exposures to laser(s) in amounts known (or suspected) to be above the ANSI Z136.1-2000 maximum permissible exposure? Yes No Unknown

With my signature, I certify that the provided information contained in this form is true and correct.

Required Signatures
______
Principal Investigator Date

GUIDELINES FOR STANDARD OPERATING PROCEDURES

·  These guidelines are intended to assist laser users in preparing standard operating

procedures (SOPs) for laser facilities. The information should be used as a guide to allow you

to develop SOPs specific to your laser systems.

·  Anyone writing operating procedures should be familiar with laser safety and the UTSA Laser

Safety Policy. The UTSA Laser Safety Policy and ANSI Z136.1 require all SOPs for laser

facilities to be approved by the LSO. It is recommended that the LSO be consulted early in

the development of SOPs for guidance in determination of the specific laser hazards and

required control measures.

·  For assistance in preparation of your facilities SOPs or laser safety concerns please contact

EHSRM at 458-6697 or 458-6101 or email at or .

I. INTRODUCTION

A.Describe the laser location.

B. Describe the laser(s) by type, classification, and technical specifications

(wavelength, power/energy, pulse length, repetition rate, beam diameter and

divergence, etc.).

C. Briefly describe the purpose of the operation.

II. HAZARDS

Identify and analyze the specific hazards associated with this laser operation; include

beam hazards as well as any non-beam hazards (electrical, hazardous chemicals, high

pressure, plume emissions, etc.).

III. HAZARD CONTROLS

Describe the means used to mitigate each of the hazards listed above in the HAZARDS

section. Please refer to 25 TAC §289.301, ANSI Z136.1-2000, the UTSA Laser Safety

Policy, or the LSO for assistance.

IV. TRAINING REQUIREMENTS

Describe the training requirements for the laser operator and incidental personnel. The

laser operator shall have formal training in laser safety as well as hands on training with

the specific laser system. Incidental personnel shall be made aware of the specific hazards

associated with the laser operation.

V. OPERATING PROCEDURES

List the sequential events that describe the complete operation, including when to

implement the hazard control measures. The procedures shall be written for the benefit of

the laser operator who must read and understand them to perform the operation safely.

VI. ALIGNMENT PROCEDURES

List the steps used to perform beam alignment on a laser or laser system. Special attention

should be given to control measures that can reduce the potential for exposure. Examples

for control measures are shutting down the main laser and using an alignment laser,

reducing the power/energy of the laser, use of beam dumps for the primary beam, etc.

Most laser accidents from the beam occur during the alignment operation.

VII. EMERGENCY PROCEDURES

Describe your planned actions in case of an accident, injury, fire, or other emergency.

Include names and phone numbers of those that must be contacted in case of an

emergency. The procedures shall include EHSRM @ 458-5250 and UTSA Police @ 911

(campus phone) or 458-4911 (cell phone). Also post the emergency procedures in the

laboratory.

VIII. RESPONSIBILITY AND REGISTRATION

State the name, title, and phone number (or office location) for the person(s) responsible

for ensuring that the operation is carried out in accordance with the SOPs.

All laser systems must be registered with EHSRM.

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